SHANNON J DUDLEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002114

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

DUDLEY

Business Name

SHANNON J DUDLEY

Original Issue Date

10/10/2003

Effective Date

03/06/2012

Expiration Date

03/01/2014

City

WICHITA

State

Zip

67206

County

KANSAS

Ever Disciplined

LastModifiedDate

04/08/2014